ReviewBMC geriatrics2023
Exploring variation in implementation of multifactorial falls risk assessment and tailored interventions: a realist review.
Review in BMC geriatrics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed.
- Evaluating a user-centered design driven multifactorial falls risk assessment tool in primary care: a randomized effectiveness-implementation study.European geriatric medicine · 2026Trial
- Explainable AI reveals temporal risk pathways in fall prediction: Extracting clinical insights from multi-horizon machine learning models.GeroScience · 2026Article
- How do falls-risk increasing drugs modify the association between index falls and future falls and fracture burden? Secondary data analysis from the Irish longitudinal study on ageing.European geriatric medicine · 2026Article
- Enhancing fall risk awareness among high fall-risk inpatients: a best practice implementation project.BMC nursing · 2026Article
- Implementing recommended falls prevention practices for older patients in hospitals in England: a realist evaluation.BMJ open · 2025Article
- Cognitive biases and contextual factors explaining variability in nurses' fall risk judgements: a multi-centre cross-sectional study.International journal of nursing studies advances · 2025Article
- Intervention to systematize fall risk assessment and prevention in older hospitalized adults: a mixed methods study.BMC geriatrics · 2025Article
- Inpatients' experiences of falls: A qualitative meta-synthesis.Journal of advanced nursing · 2025Review
- Timed Up and Go test score and factors associated with a moderate-to-high risk of future falls in patients scheduled for vascular surgeries-a cross-sectional study.Frontiers in public health · 2024Article
- Targeted optimum care approach for osteoporotic fragility fractures: tailored strategy based on risk stratification to reduce incidents of falls-an initiative by the Egyptian Academy of bone health based on the FLS national register.Archives of osteoporosis · 2023Observational
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundFalls are the most common safety incident reported by acute hospitals. In England national guidance recommends delivery of a multifactorial falls risk assessment (MFRA) and interventions tailored to address individual falls risk factors. However, there is variation in how these practices are implemented. This study aimed to explore the variation by examining what supports or constrains delivery of MFRAs and tailored interventions in acute hospitals.
methodsA realist review of literature was conducted with searches completed in three stages: (1) to construct hypotheses in the form of Context, Mechanism, Outcome configurations (CMOc) about how MFRAs and interventions are delivered, (2) to scope the breadth and depth of evidence available in Embase to test the CMOcs, and (3) following prioritisation of CMOcs, to refine search strategies for use in multiple databases. Citations were managed in EndNote; titles, abstracts, and full texts were screened, with 10% independently screened by two reviewers.
resultsTwo CMOcs were prioritised for testing labelled: Facilitation via MFRA tools, and Patient Participation in interventions. Analysis indicated that MFRA tools can prompt action, but the number and type of falls risk factors included in tools differ across organisations leading to variation in practice. Furthermore, the extent to which tools work as prompts is influenced by complex ward conditions such as changes in patient condition, bed swaps, and availability of falls prevention interventions. Patient participation in falls prevention interventions is more likely where patient directed messaging takes individual circumstances into account, e.g., not wanting to disturb nurses by using the call bell. However, interactions that elicit individual circumstances can be resource intensive and patients with cognitive impairment may not be able to participate despite appropriately directed messaging.
conclusionsOrganisations should consider how tools can be developed in ways that better support consistent and comprehensive identification of patients' individual falls risk factors and the complex ward conditions that can disrupt how tools work as facilitators. Ward staff should be supported to deliver patient directed messaging that is informed by their individual circumstances to encourage participation in falls prevention interventions, where appropriate.
trial registrationPROSPERO: CRD42020184458.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.